Cost-effectiveness analysis of clinical specialist outreach as compared to referral system in Ethiopia: an economic evaluation
Open accessAbstract
BACKGROUND: In countries with scarce specialized Human resource for health, patients are usually referred. The other alternative has been mobilizing specialists, clinical specialist outreach. This study examines whether clinical specialist outreach is a cost effective way of using scarce health expertise to provide specialist care as compared to provision of such services through referral system in Ethiopia. METHODS: A cross-sectional study on four purposively selected regional hospitals and three central referral hospitals was conducted from Feb 4-24, 2009. The perspective of analysis was societal covering analytic horizon and time frame from 1 April 2007 to 31 Dec 2008. Data were collected using interview of specialists, project focal persons, patients and review of records. To ensure the propriety standards of evaluation, Ethical clearance was obtained from Jimma University. RESULTS: It was found that 532 patients were operated at outreach hospitals in 125 specialist days. The unit cost of surgical procedures was found to be ETB 4,499.43. On the other hand, if the 125 clinical specialist days were spent to serve patients referred from zonal and regional hospitals at central referral hospitals, 438 patients could have been served. And the unit cost of surgical procedures through referral would have been ETB 6,523.27 per patient. This makes clinical specialist outreach 1.45 times more cost effective way of using scarce clinical specialists' time as compared to referral system. CONCLUSION: Clinical specialist outreach is a cost effective and cost saving way of spending clinical specialists' time as compared to provision of similar services through referral system.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Nineteen studies were ex-post economic evaluations; of those, 17 were cost-effectiveness analyses.
“Nineteen studies were ex-post economic evaluations of which 17 were CEAs with one CUA [7, 12, 14, 15, 17] [18–30, 33].”
From Use of health economic evaluation in the implementation and improvement science fields—a systematic literature review (2019) · cites this paper as [19]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Methods for the Economic Evaluation of Health Care Programmes
Drummond, M. E., Sculpher, M. J., Torrance, G. W., O’Brien, B. J., & Stoddart, G. L. (2005) · doi:10.1093/oso/9780198529446.001.0001 · Cited by 13,648 · see citing works
Indirect costs associated with accessing eye care services as a barrier to service use in Ethiopia
Melese, M., Alemayehu, W., Friedlander, E., & Courtright, P. (2004) · Tropical Medicine & International Health · doi:10.1111/j.1365-3156.2004.01205.x · Cited by 144 · see citing works
Assistance in developing a custom-made prosthetic eye service.
Gruen, R., Weeramanthri, T., Knight, S., & Bailie, R. (2006) · Europe PMC (PubMed Central) · Cited by 112 · see citing works
Gruen, R. L., O'Rourke, I. C., Bailie, R. S., D'Abbs, P. H., O'Brien, M. M., & Verma, N. (2001) · The Medical Journal of Australia · doi:10.5694/j.1326-5377.2001.tb143400.x · Cited by 76 · see citing works
Systematic review of outreach clinics in primary care in the UK
powell, J. A. (2002) · Journal of Health Services Research & Policy · doi:10.1258/135581902760082490 · Cited by 73 · see citing works
Investigation of benefits and costs of an ophthalmic outreach clinic in general practice.
Gillam, S., Ball, M., Prasad, M., Dunne, H., Cohen, S., & Vafidis, G. C. (1995) · Europe PMC (PubMed Central) · Cited by 40 · see citing works
The Efficiency of Specialist Outreach Clinics in General Practice: Is Further Evaluation Needed?
Gosden, T., Black, M. E., Mead, N., & Leese, B. (1997) · Journal of Health Services Research & Policy · doi:10.1177/135581969700200309 · Cited by 36 · see citing works
O'Brien, K. D., Mattick, R. P., Mandall, N., Wright, J., Conboy, F., & Gosden, T. (2001) · BDJ · doi:10.1038/sj.bdj.4801140 · Cited by 11 · see citing works
O'Brien, K., Mattick, R., Mandall, N., et al. (2001) · BDJ · doi:10.1038/sj.bdj.4801140a · Cited by 3 · see citing works
Flagged first, then by citations
Research works printed but not linked: 1
- Gruen R Weeramanthri T Knight S Bailie R Specialist outreach clinics in primary care and rural hospital settings (Cochrane Review) Community Eye Health 2006 19 58 31 17491730 PMC1705641
Cited by
Sorted by citations
Roberts, S. L. E., Healey, A., & Sevdalis, N. (2019) · Implementation Science · doi:10.1186/s13012-019-0901-7 · Cited by 161 · see citing works
Verguet, S., Olson, Z. D., Babigumira, J. B., Desalegn, D., Johansson, K. A., Kruk, M. E., Levin, C., Nugent, R. A., Pecenka, C. J., Shrime, M. G., et al. (2015) · The Lancet Global Health · doi:10.1016/s2214-109x(14)70346-8 · Cited by 107 · see citing works
Duvall, S., Thurston, S., Weinberger, M., Nuccio, O., & Fuchs-Montgomery, N. (2014) · Global Health Science and Practice · doi:10.9745/ghsp-d-13-00116 · Cited by 105 · see citing works
Verguet, S., Memirie, S. T., & Norheim, O. F. (2016) · BMC Medicine · doi:10.1186/s12916-016-0697-0 · Cited by 44 · see citing works
Shrime, M. G., Verguet, S., Johansson, K. A., Desalegn, D., Jamison, D. T. T., & Kruk, M. E. (2015) · Health Policy and Planning · doi:10.1093/heapol/czv121 · Cited by 35 · see citing works
Tansley, G., Stewart, B. T., Gyedu, A., Boakye, G., Lewis, D. J., Hoogerboord, M., & Mock, C. (2016) · World Journal of Surgery · doi:10.1007/s00268-016-3765-x · Cited by 27 · see citing works
Mixed-methods assessment of surgical capacity in two regions in Ethiopia
Iverson, K. R., Garringer, K., Ahearn, O., Alidina, S., Citron, I., Esseye, S., Teshome, A., Mukhopadhyay, S., Burssa, D., Collaborators, S. S. 2., et al. (2019) · British journal of surgery · doi:10.1002/bjs.11032 · Cited by 27 · see citing works
Osebo, C., Grushka, J. R., Deckelbaum, D., & Razek, T. S. (2024) · Surgery Open Science · doi:10.1016/j.sopen.2024.03.015 · Cited by 19 · see citing works
Zegeye, E. A., Reshad, A., Bekele, E. A., Aurgessa, B., & Gella, Z. (2018) · Value in Health Regional Issues · doi:10.1016/j.vhri.2018.07.001 · Cited by 11 · see citing works
Shrime, M. G., Verguet, S., Johansson, K. A., Desalegn, D., Jamison, D. T. T., & Kruk, M. E. (2015) · World Bank, Washington, DC eBooks · doi:10.1596/978-1-4648-0346-8_ch19 · Cited by 10 · see citing works
ge, S., Zhou, B., Cai, Z.-C., Wu, T., Li, X.-F., & Xu, W. (2014) · Rural and Remote Health · doi:10.22605/rrh2317 · Cited by 9 · see citing works
Geta, E. T., Siraneh, Y., & Yesuf, E. A. (2019) · Journal of Public Health in Africa · doi:10.4081/jphia.2019.1024 · Cited by 5 · see citing works
Isichei, M., Misauno, M. A., Shitta, A. H., Isichei, C. O., & Enwerem, K. E. (2014) · IOSR Journal of Dental and Medical Sciences · doi:10.9790/0853-13455354 · Cited by 2 · see citing works
- Authors
- Kifle, Y. A., & Nigatu, T. H.
- Affiliations
- Jimma University (ET)
- Amref Health Africa (TZ)
- Corresponding author
- Kifle, Yibeltal A
- Venue
- Cost Effectiveness and Resource Allocation
- Published
- 2010
- Volume
- 8
- Issue
- 1
- Pages
- 13
- ISSN
- 1478-7547 (ISSN-L)
- PMC
- PMC2892431
- OpenAlex
- W2105016127
- Cited by
- 13
- References
- 9
- Citations by year
- 2024: 1 · 2019: 3 · 2018: 1 · 2016: 2 · 2015: 3 · 2014: 3
- FWCI
- 0.00
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Cost Effectiveness and Resource Allocation (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Minerva Access (University of Melbourne) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Bundesministerium für Gesundheit
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Global Health and Surgery
- Health Sciences › Health Professions › Emergency Medical Services › Global Health Workforce Issues
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
- Keywords
- referral systems, cost-effectiveness, specialist workforce shortage, surgical procedures, unit cost, regional hospital, referral hospitals, Ethiopia
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
